Online Registration

Please fill up all fields of information (Capital Letters only)

Admission sought in Class

Particulars of the child/ Ward

Name

Gender

malefemale

Date of Birth

Residential Address

Particulars of the Father

Name

Educational Qualifications

Occupation

Name of the Organization

Contact No. 1.

Contact No. 2.

E-mail

Particulars of the Mother

Name

Educational Qualifications

Occupation

Name of the Organization

Contact No. 1.

Contact No. 2.

E-mail

Other Details

Transport facility

Hostel Facility
RequiredNot Required

Landmark from where transport pick up & drop required

Previous Schooling

Specify Previous School Name & Address (if applicable)

Is your child toilet-trained?

How many siblings does the child have?

Brothers (mention name & age)
(1)

(2)

Sisters (mention name & age)
(1)

(2)

History of past illness of the child/ Ward

Specific ailments suffered in the past

Specify (if yes)

Surgery undergone

Specify (Is Yes)

Allergy

Specify (if yes)

Does your child suffer from any phobia ?

Specify (if yes)

Is the child presently on any regular medication ?

Specify (if yes)

Any special instructions

Declaration by Parent/Guardian

I declare that the information given is correct and complete.

I have not withheld any information.